One of the things I’ve come to realise recently is that there can be a world of difference between the beliefs and perceptions of a depressed person, and beliefs and perceptions of someone looking at that same person from the outside.
A person may be depressed because they are mired in feelings of guilt, shame, inadequacy and failure. It’s really hard to ask for help when you know that the problems are of your making. The perception of being the cause of all that is wrong may not be accurate, but it makes expressing distress impossible – it would just add more shame and humiliation to the mix.
A depressed person may feel guilt and shame because they see the things that are hurting them as fairly minor compared to the ’real’ problems out there in the world, and they are embarrassed to make a fuss about what seem like trivial things.
A person who is not coping may feel that it is their fault because they can’t be positive enough. We all know the memes about life is what you make it, and gratitude and making the best of things. A person in too much pain may feel guilty that they aren’t appreciative enough, aren’t trying hard enough. They may feel they should be able to think better and expect to be blamed if they express distress.
A person may feel as though they deserve to suffer – for the above reasons, and also because they may believe they’re basically no good and that the ‘like attracts like’ idea is true and that things happen to them because they deserve it. Someone who has been groomed for abuse, is especially likely to feel that they deserve what was done to them.
Fear of having your feelings rubbished keeps a person silent. If expressing pain generally leads to being told why you shouldn’t feel that way, then you soon learn not to mention it. If you are treated as melodramatic, making a fuss, being unreasonable, then you learn to stay silent and will likely feel more to blame and more at fault for your depression as a consequence.
Not wanting to deal with unhelpful feedback keeps people silent. The world and his dog feel entitled to hand out unsolicitied medical advice – eat this, don’t eat that, do this therapy, practice mindfulness… as though we depressed people have never tried to find solutions, and as though our problems are really caused by us, and not by circumstances. Almost every ‘cure’ for depression assumes the problem is the sufferer, but increasingly the evidence suggests that depression is caused by experience. Interventions that reinforce the responsibility of the sufferer can be really awful to encounter when suffering, silence protects us from this and from further cycles of guilt and shame, caused by feeling responsible for a depression you cannot fix.
It’s like having a sharp piece of metal stuck in your body. You may be offered pain killers. You may be told it would hurt less if you got more exercise and lost some weight. You should meditate to take your mind off the pain. You should be more grateful for other things and not pay so much attention to the sharp piece of metal. You should realise that the sharp piece of metal is a gift from the universe for your highest good. And this of course sounds like the total rubbish it is. If a person has a sharp piece of metal stuck in their body, the answer is a careful intervention that gets the metal out, cleans and closes the wound and gives them time to recover.
If we ask people why they are hurting, and what would help, and are prepared to hear it and do something with it, some of those wounds on the inside could also be cleaned, closed and healed.